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Objective To evaluate the value and the expression of Axl receptor tyrosine kinase (AxlTK) in renal pathology of lupus nephritis (LN) patients. Methods The expression of AxlTK were detected in 29 LN and 10 primary nephritic syndrome (NS) patients using immunohistochemistry in renal tissue. The correlations between the levels of AxlTK on glomeruli and clinical manifestations, laboratory parameters, disease activity, and renal pathology in LN patients were investigated. T test and single factor analysis of variance were used tp compare between groups, and Pearson or Spearman test was used for correlation analysis. Results AxlTK was extensively expressed on surface of mesangial cells, endothelial cells in glomeruli. There was more expression of AxlTK on mesangial cells in LN patients [(7.0 ±2.2)×10-2] than that in primary NS patients [(3.1 ±1.2) ×10-2] (t=5.382, P0.05). Conclusion The expression of Axl TK in glomerular is significantly increased in glomeruli in LN patients. The expression level of AxlTK on glomeruli is correlated with the occurrence of oral ulcers and AnuA. The level of AxlTK expression is related to pathological categories of kidney in LN patients. The results of this study suggest that AxlTK might participate in the pathogenesis of LN.
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Objective To explore the expression and clinical significance of soluble Axl and Tyro3 receptor tyrosine kinase in systemic lupus erythematosus (SLE).Methods Sandwich enzyme linked immunosorbent assay (ELISA) was used to detect sAxlTK and sTyro3TK in the serum of 140 SLE patients,150 disease controls and 100 healthy controls (HC).The relationships between the serum levels of sAxlTK/sTyro3TK and clinical manifestations,laboratory parameters,disease activity were analyzed in SLE patients.Analysis of variance,Dunnett's t-test,chi-square test and spearman's test were used for statistical analysis.Results The concentrations of sAxlTK [(56±18) ng/ml] and sTyro3TK [(3.9±1.6) ng/ml] were both elevated in serum of SLE patients,which were significantly higher than disease controls [sAxlTK:(41±17) ng/ml;sTyro3TK:(2.6± 1.2) ng/ml] and healthy controls [sAxlTK:(37±10) ng/ml;sTyro3TK:(2.1±0.7) ng/ml].The SLE sAxlTK levels were negatively correlated with lymphocyte count (r=-0.266,P=0.002),hemoglobin (r=-0.480,P＜0.01),platelet count (r=-0.374,P＜0.01),albumin (r=-0.465,P＜0.01),estimated glomerular filtration rate (eGFR,r=-0.230,P=0.006),complement C3 (r=-0.399,P＜0.01) and complement C4 (r=-0.374,P＜0.01).However,the levels of sAxlTK in SLE patients were positively correlated with D-dimer (r=0.371,P＜0.01),creatinine (r=0.278,P＜0.01),24-hour urinary protein quantification (r=0.383,P＜0.01),erythrocyte sedimentation rate (r=0.422,P＜0.01),titre of anti-nuclear antibodies (r=0.271,P=0.002),anti-dsDNA antibody (r=0.299,P＜0.01),anti-nucleosome antibody (r=0.263,P=0.013) and anti-cardiolipin antibody (r=0.309,P＜0.01).In addition,the levels of serum sAxlTK in SLE patients showed positive correlation with the scores of SLEDAI (r=0.307,P＜0.01).Comparisons of sAxlTK levels between patients with high and low disease activity demonstrated a higher level of sAxlTK in the former [(64±17) ng/ml vs (52±16) ng/ml;t=-3.939,P＜0.01].Conclusion The levels of sAxlTK and sTyro3TK are elevated in the serum of SLE patients.The concentration of sAxlTK is correlated with autoantibodies production,hematological and renal involvement in SLE,which may be a serolgical marker for disease activity.
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Objective To explore the status of glucocorticoid application in patients with systemic lupus erythematosus (SLE) in China.Methods Epidemiological survey was used.The SLE patients who met the 1997 classification criteria of American College of Rheumatology were enrolled.The usage of glucocorticoid and related adverse reactions were recorded and analyzed.Results A total of 400 SLE patients were enrolled,including 35 men and 365 women.The average age was (37.4 ± 14.0) years old,and the average duration of disease was (6.7 ± 5.8) years.There were 310 patients using glucocorticoid as maintenance.Sixty-one percent (n =244) patients started using medium dose (prednisone 30-＜ 60 mg/d) as the initial treatment of glucocorticoid,which lasted for (37 ± 11) days.The time of drug duration in patients with low dose prednisone (7.5-＜30 mg/d)and high dose (60-100 mg/d) was(92 ± 20)and (17 ± 3) days respectively (P ＜ 0.05 between 3 groups).However,patients receiving different initial dosage were of no discrepancy in the maintenance therapy.During maintenance,even though 51.0％ (n =158) patients were on prednisone 2.5-5 mg/d,the duration of drug use in ＞ 5-10 mg/d groupwas longer [(29.9 ± 3.3) months].Patients with involvement of internal organs had a higher tendency to use 60-100 mg/d prednisone or pulse-dose therapy in the initial treatment,nevertheless these two groups had no difference of maintenance dosage.Among all 400 patients,62 patients withdrew glucocorticoid,including 17 patients with disease remission (4.3％),44 by self-withdrawal and one with adverse reaction.Conclusion In China,the medium dosage of glucocorticoid is the most common initial treatment in patients with SLE.Prednisone 2.5-5 mg/d was the most common choicefor maintenance therapy.Currently,the proportion of glucocorticoid withdrawal remains low in SLE patients achieving remission.
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Objective To investigate the clinical significance of soluble Mer receptor tyrosine kinase (sMerTK) in patients of systemic lupus erythematosus.Methods sMerTK was detected in the serum of 101 SLE patients,96 disease controls and 62 healthy controls (HC) by sandwich enzyme-linked immunosorbent assay (ELISA).The relationships between the serum levels of sMerTK and clinical manifestations,laboratory parameters,disease activity were investigated in SLE patients.Comparisons between groups were tested by t-test and x2 test,Correlation of parameters were analyzed by Spearman method.Results sMerTK levels in SLE patients [(10.6±6.0) ng/ml] was significantly higher than disease controls [(4.4±2.0) ng/ml] (t=9.704,P＜0.01) and healthy controls [(2.8±2.5) ng/ml] (t=11.505,P＜0.01).The concentrations in SLE patients were independent of gender,age and disease duration.The levels of sMerTK were negatively correlated with white blood cell (r=-0.236,P=0.017),hemaglobin(r=-0.354,P＜0.01),platelet values (r=-0.310,P=0.002).Compared with the patients without lupus nephritis (LN)[(9±6) ng/ml],patients with LN had higher concentrations in serum [(11±6) ng/ml],and the difference was statistically significant (t =2.071,P=0.041).In addition,sMerTK levels were also correlated with 24 h-urinary protein level (r=0.293,P=0.013),serum creatinine (r=0.250,P=0.035) and e-GFR (r=-0.201,P=0.045).Furthermore this study indicated that sMerTK was negatively correlated with C3 (r=-0.447,P＜0.01) and C4 (r=-0.357,P＜0.01)level,but positively correlated with anti-dsDNA antibody titers (r=0.360,P＜0.01),anti nucleosome antibody (AnuA) (r=0.264,P=0.016) and SLEDAI (r=0.473,P＜0.01).Conclusion sMerTK level is increased in SLE patients.The concentration may associate with hematology changes and lupus nephritis.It may be an indicator of disease activity.
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Objective To investigate the significance of plasma protein S and growth-arrest specific protein 6 (Gas6) in systemic lupus erythematosus (SLE).Methods Sandwich enzyme-linked immunosorbent assay (ELISA) was used to measure the protein S and Gas6 in the plasma of 103 SLE patients and 40 healthy controls.Mann-Whitney U-test,x2-test and Spearman's rank correlation were used for statistical analysis.Results The plasma concentrations of protein S and Gas6 were both significantly [protein S:30.6 (27.2,33.6) μg/ml,37.8(35.4,46.7) μg/ml,Z=6.04,P＜0.01; Gas6:402.6(239.2,757.8) pg/ml,913.6(765.0,1 290.6) pg/ml,Z=4.26,P＜0.01] decreased in plasma of SLE patients than that in healthy controls.There was a positive correlation between levels of protein S and Gas6 (r=0.312,P=0.001).The level of protein S in SLE patients was positively correlated with hemoglobin (Hb),WBC,platelet blood platelet (PLT),C3 and C4 (r=0.209,0.264,0.264,0.362,0.280,P＜0.01 or P＜0.05).Plasma protein S level was also found to be negatively correlated with auto-antibodies such as anti-double strand DNA (anti-dsDNA) antibody,anticardiolipin (ACL),anti-nucleosome antibody (AnuA) or IgG (r=-0.197,-0.264,-0.226,-0.229,P＜0.01or P＜0.05).The plasma Gas6 level was positively associated with age,disease duration and C-reaction protein (CRP) (r=0.229,0.198,0.263,P＜0.01 or P＜0.05).Patients with decreased Gas6 level showed higher incidence of fever,rash and serositis.Patients with decreased WBC or positive for proteinuria also showed decreased Gas6 (P＜0.05).Conclusion Protein S levels are significantly decreased in plasma of SLE patients and is associated with a series of severe disease manifestations such as hematological involvement,decreased complements and the presence of auto-antibodies.Decreased Gas6 levels in SLE patients are observed and they are correlated with age,disease duration and certain clinical characteristics such as rash,renal involvement and inflammatory response.